Abstract
OBJECTIVE: To compare the outcomes of simultaneous versus staged minimally invasive surgery in elderly patients with combined osteoporotic extremity fractures and vertebral compression fractures (VCFs). METHODS: A retrospective analysis was conducted on 118 patients (aged 60-82 years), randomized into two groups: simultaneous (n=59) and staged (n=59). The outcomes measured included re-fracture rates, SF-36, surgical parameters, healing time, functional scores (Constant-Murley, Cooney, Harris, ODI), and complications. RESULTS: The simultaneous group had a longer operative time, but significantly reduced blood loss and fewer internal fixations (all P<0.01). Pain relief was faster and more sustained in the simultaneous group at 6 months (P<0.05), with superior functional scores (Constant-Murley, Cooney, Harris) at 1-3 months (P=0.047) and maintained upper limb benefits at 6 months. Spinal function (ODI) improved by 30% more in the simultaneous group (P<0.01). Fracture healing was accelerated across all sites (P<0.01), and complications, including cement leakage (P=0.022) and surgical site infections (P=0.049), were significantly lower. SF-36 scores for physical function, pain, vitality, and social function showed 12-18% superiority in the simultaneous group at 3-6 months (P=0.029). CONCLUSIONS: Simultaneous minimally invasive surgery reduces pain, accelerates recovery, and lowers complications without increasing re-fracture risk, making it a safer treatment strategy for elderly patients with combined osteoporotic fractures.